Catheter-Directed Thrombolysis in the Treatment of Acute Ischemia in Lower Extremities Is Safe and Effective, Especially with Concomitant Endovascular Treatment

Urbak, Lærke; Motte, Louise de la; Rørdam, P; Siddiqi, A. H.; Sillesen, Henrik

doi:10.3400/avd.oa.16-00140

Cited by 10 publications

(8 citation statements)

References 11 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7 Urbak et al have reported that the mortality rate is 3% in one month, but it reaches 22% in seven years. 10 In our study, while the one-month mortality rate of the patients was 16.67%, the one-year mortality rate was 50%, and only one patient underwent phalanx amputation. High mortality rate might stem from other systemic disease occurring at large frequency, such as pulmonary thromboembolism, hypertension, and heart failure those accompany to peripheral artery occlusion.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

An Overlook at the Patients with Acute Lower Limb Ischemia Undergone Femoral Embolectomy

Tural¹,

Avcı²,

Altınbaş³

2017

Emerg Med Open J

View full text Add to dashboard Cite

Objectives: Acute lower extremity ischemia is a rapidly progressive condition that could stem from embolism or thrombus, leading to sudden interruption of blood flow which might cause loss of limb or even mortality. In this study, the registries of the patients having acute lower limb ischemia who has previously undergone femoral embolectomy in our center were assessed, retrospectively. Additionally, relevant literature on this topic were reviewed. Materials and Methods: The data were obtained from the hospital records of 18 patients with acute lower limb arterial thrombosis ischemia who have undergone femoral artery thromboembolectomy between January 2011 and January 2017. Results: The age range of 61.1% of the patients is between 65 and 84. 1-month, 6-month, and 1-year mortality rates of the patients are 16.67%, 27.78% and 50%, respectively. A significant portion of the patients having acute lower limb ischemia has a concomitant systemic atherosclerotic disorder in the pre-operative period. High mortality and morbidity rates occur as a result of coexisting medical comorbidities of patients with acute lower limb ischemia (ALLI). Conclusion: It is crucial to take various risk factors, such as hypertension, diabetes, atrial fibrillation under control and start an immediate treatment for the prevention of multiorgan failure in the case of acute lower limb ischemia.

show abstract

Section: Discussionmentioning

confidence: 98%

“…9 In the study reported by Urbak et al, 63% of patients had previously known peripheral arterial disease. 10 Likewise, in our study, peripheral arterial disease was previously determined in 10 of 18 patients.…”

Section: Discussionmentioning

confidence: 99%

An Overlook at the Patients with Acute Lower Limb Ischemia Undergone Femoral Embolectomy

Tural¹,

Avcı²,

Altınbaş³

2017

Emerg Med Open J

View full text Add to dashboard Cite

show abstract

“…Thrombotic presentations of COVID-19 are really serious. Acute arterial thrombosis in the extremities may end in limb loss if left untreated [8] while deep venous thrombosis may lead to fatal PE. The latter may occur following a silent DVT.…”

Section: Discussionmentioning

confidence: 99%

Catheter directed thrombolysis for acute deep vein and arterial thrombosis in COVID-19: report of two cases from Sulaymaniyah, Kurdistan-Iraq

Mirza¹,

Taha

2021

JFacMedBagdad

View full text Add to dashboard Cite

As one year elapsed since COVID-19 outbreak, venous and arterial thromboses are increasingly reported in different vascular territories. Once accessed by the virus, the endothelial cells, abundant in angiotensin converting enzyme-2 (ACE-2) protein, will be activated by the inflammatory process leading to coagulopathy and vascular lesions. Herein, we describe a case of extensive thrombosis of the infra-renal inferior vena cava and iliac femoral vein in a man of 62 and a case of acute superficial femoral artery thrombosis in a lady of 55. Both were COVID-19 confirmed cases with severe pneumonia, high D-Dimer levels and risk factors for severe disease or death. Despite presentation 1-2 weeks after the onset of thromboses, they were successfully managed by catheter directed thrombolysis (CDT) using tissue plasminogen activator (tPA). Owing to the increased morbidity and mortality of vascular thrombosis, there is a need to identify COVID-19 patients who need prophylaxis and prescribe them the right prophylactic drug (s). The excellent outcome of CDT in these two patients, from Sulaymaniyah/Iraq, supports the use of this treatment modality as a valid, safe and effective option for acute arterial and venous thromboses.

show abstract

“…CDT can be used in combination or as an adjunct to other treatment approaches, after percutaneous thrombus aspiration, mechanical thrombectomy or PTA [40]. Some studies found significantly better patency in patients treated with CDT and angioplasty than in those treated with CDT alone [41].…”

Section: Catheter-directed Thrombolysis (Cdt)mentioning

confidence: 99%

Current Treatment Options in Acute Limb Ischemia

Fluck

Augustin

Bley

et al. 2019

Fortschr Röntgenstr

View full text Add to dashboard Cite

Background Acute limb ischemia represents a clinical emergency with eventual limb loss and life-threatening consequences. It is characterized by a sudden decrease in limb perfusion. Acute ischemia is defined as a duration of symptoms for less than 14 days. Aging of the population increases the prevalence of acute limb ischemia. The two principal etiologies are arterial embolism and in situ thrombosis of an atherosclerotic artery. Immediate diagnosis, accurate assessment and urgent intervention when needed are crucial to save the limb and to prevent a major amputation. Delay in diagnosis and therapy may lead to irreversible ischemic damage. Method To assess the current treatment options in acute limb ischemia, this review is based on a selective literature search in PubMed representing the current state of research. Results and Conclusion Patients with acute limb ischemia should receive immediate anticoagulation. Treatment depends on the classification based on the degree of ischemia and limb viability. Especially acute (< 14 days symptom duration) Rutherford Categories IIa and IIb with marginally and immediately threatened limbs require definitive therapeutic intervention and are salvageable, if promptly revascularized. The current literature suggests that open surgical revascularization is more time effective then catheter-directed thrombolysis. However, with the advent of thrombolytic delivery systems and mechanical thrombectomy devices, treatment time can be minimized and successful utilization in patients with Category IIb (Rutherford Classification for Acute Limb Ischemia) has been reported with promising limb-salvage and survival rates. Large randomized studies are still missing, and guidelines suggest choosing the method of revascularization depending on anatomic location, etiology, and local practice patterns, with the time to restore the blood flow being an important factor to consider. Key points: Citation Format

show abstract

Catheter-Directed Thrombolysis in the Treatment of Acute Ischemia in Lower Extremities Is Safe and Effective, Especially with Concomitant Endovascular Treatment

Cited by 10 publications

References 11 publications

An Overlook at the Patients with Acute Lower Limb Ischemia Undergone Femoral Embolectomy

An Overlook at the Patients with Acute Lower Limb Ischemia Undergone Femoral Embolectomy

Catheter directed thrombolysis for acute deep vein and arterial thrombosis in COVID-19: report of two cases from Sulaymaniyah, Kurdistan-Iraq

Current Treatment Options in Acute Limb Ischemia

Contact Info

Product

Resources

About